Individual provider Active NPI

Jalil Haddad, PA

  • Physician Assistant
  • Totowa, NJ
National Provider Identifier
1922838143
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00866000 Issued in NJ
Practice address
225 Minnisink Rd Ste 103
Totowa, NJ 07512-1804
Phone
(862) 657-3100
Fax
(862) 657-3100
NPI assigned
Aug 2, 2024
Last updated
Jan 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00866000 NJ Primary

Addresses

Primary practice location

225 Minnisink Rd Ste 103
Totowa, NJ 07512-1804

Mailing address

225 Minnisink Rd Ste 103
Totowa, NJ 07512-1804
Phone (862) 657-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906003429 NJ Practitioner - Physician Assistant 7517407398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 -22 Banta PL
Fair Lawn, NJ 07410-3058

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00866000NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Healthcare, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1922838143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MINNISINK RD STE 103",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121804",
            "telephone_number": "862-657-3100",
            "fax_number": "862-657-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MINNISINK RD STE 103",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121804",
            "telephone_number": "862-657-3100",
            "fax_number": "862-657-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "JALIL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-02",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00866000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

Verify at the official NPI Registry.